But despite mandates for preventive services with zero cost-sharing, a large and growing share of ACA exchange enrollees never submit a claim, meaning they apparently use none of the services their policies cover—preventive or otherwise.
Since Obamacare eliminated potential financial cost barriers to preventive services, why would so many covered individuals never obtain any services at all—not even a well-visit or screening?
When someone has coverage with “first-dollar” preventive services but makes no use of the system, some possible explanations arise. They may be healthy and have no need for care in that year. Or they may lack access (such as provider network issues) or awareness that preventive services are free. Finally, we have to consider whether they are improperly enrolled, or a phantom enrollee.
In either of the latter two cases, Obamacare’s assumption—that coverage leads to preventive care uptake, better health, and lower costs—is significantly undermined.